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Periodontitis: hidden causes

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Q:My husband has been told he has periodontitis and must have the area between his gums and his teeth cleaned out, for a lot of money

Q:My husband has been told he has periodontitis and must have the area between his gums and his teeth cleaned out, for a lot of money. His teeth are excellent. At the age of 50 he has hardly any fillings. He is meticulous in his dental hygiene. I

A:Dental plaque are microorganisms which attach themselves to the enamel surfaces of our teeth, feeding on substances from our diet and saliva. If allowed to grow and colonize on tooth surfaces, they will eventually cause cavities and gum disease and eventually destroy the teeth. If this plaque, harmless in itself, is not thoroughly removed after 24-36 hours, it can accumulate and harden into tartar, producing toxins which inflame gums (gingivitis), causing them to become red and puffy and often to bleed during brushing. They may also slightly recede away from the teeth. At this point, the damage is reversible, since the underlying bone is not affected; left untreated, the situation develops into periodontitis, where the gums markedly recede and the bone degenerates, resulting in loose teeth.

We spoke with our panel member Jack Levenson and also Dr Jerome Mittelman, a holistic dentist in New York. Both agree that plaque should be removed every day as part of your daily hygiene and tartar must be periodically removed by a dentist. However, even if your teeth are meticulously polished and descaled, in 24 hours plague will reappear, and so it is not simply a matter of going to the dentist regularly.

Gum disease depends on many factors, not simply how frequently your teeth are cleaned. The state of your gums reflects both the state of your immune system and your diet. Bacteria in your mouth mainly feed on carbohydrates and sugar, particularly refined sucrose, which is a source of fermentation for bacteria. The more sugar you eat, the higher the level of lactic acid in your mouth, which promotes tooth decay.

Oftentimes patients with gum disease have marked nutritional deficiencies. In one study, Dr Edward Wilkinson, a periodontal specialist, found that patients with diseased gums had a huge deficiency of coenzyme Q-10. Once they were supplemented with the enzyme, the researchers were able to reverse the gum conditions (William Lee, Coenzyme Q-10, Keats Publishing). Other studies have shown marked deficiencies of coenzyme Q-10 in gum tissue ranging from 60 to 96 per cent! In another double blind, randomized study, 18 patients with periodontal disease were given either coenzyme or a placebo. After three weeks, the eight patients receiving the enzyme showed impressive improvement in a number of factors, including the gaps between gum and teeth, swelling, bleeding, redness, pain and looseness of teeth. It's also been shown in another study to improve healing and tissue repair after surgery (Holistic Dental Digest, Supplement no 2).

Another study of periodontal patients showed that patients with higher vitamin E blood levels had less bleeding (Holistic Dental Digest). Besides vitamin E and coenzyme Q-10, nutritionist Jeffrey Bland recommends that patients have adequate supplements of calcium, magnesium and phosphorus, vitamin C, zinc, vandium and silicon all important for bone health plus the omega-3 and omega-6 fatty acids. (The magnesium will also help with night grinding.) Dr Mittelman says that he finds patients who have a high protein breakfast with vitamin C and calcium also improved the status of gum problems.

Unfortunately, the dental establishment battles gum disease by blasting out the germs in your mouth with ever more powerful implements and mouthwashes, rather than dealing with the source of the problem or trusting a healthy human body to deal with it adequately. The latest treatment is identifying the bacteria in a gum patient's mouth and administering powerful, long term antibiotics.

However, everyone's resistance to gum disease is different. If a diabetic doesn't brush his teeth for a few days, his gums might look bloody and puffy. If a healthy young athlete neglects his teeth for several days, his gums will be perfectly fine. The state of your gums isn't simply to do with hygiene, but the state of your immune system, the way you breathe and whether you are undergoing stress.

One overlooked source of gum disease is mouth breathing. Ordinarily, if your diet and intake of nutrients is adequate, your free flowing saliva should keep germs under control with proper dental hygiene. However, many people who sleep with their mouth open dry up their own saliva, which causes more gum disease. Another potential problem is incorrect swallowing, says Dr Mittleman. He claims there is evidence that some three quarters of all adults incorrectly swallow, stemming from rubber nipples and bottles. Bottlefed babies, used to placing their tongue in the wrong position to keep from choking on milk pouring in, develop incorrect methods of swallowing, taking in lots of air when they eat, which also dries up saliva. Instead of bracing the teeth against the roof of the mouth, which has the effect of dumping food into the throat for swallowing, many adults and children push food against their teeth, causing a heavily build up of bacteria. This can be corrected by therapy.

Dental mercury amalgam fillings are also frequent culprits of periodontal disease; although you say your husband doesn't have many fillings, you may wish to have any metal ones changed (see our Dental Handbook for more information on mercury problems).

Night grinding and traumatic bites can also cause receding gums.

Another overlooked problem is stress. The Journal of Periodonitia (47: 67) discovered that emotional stress is a large factor in periodontal disease. In their review, the journal examined soldiers at war who suffered unusually marked gum disease, which couldn't be explained by anything other than continued stress. Stress causes your mouth to produce less saliva, and the saliva there to become more acidic. Stress reduction exercise, meditation or biofeedback should help.

Finally, a solution of warm water mixed with a tablespoon of aloe vera gel (or the gel applied directly to the affected area, will soothe and heal inflamed, bleeding gums.